Association of Geriatric Nutritional Risk Index With Cardiovascular and All-Cause Mortality Among US Elderly Adults...

This study examines the association between the Geriatric Nutritional Risk Index (GNRI) and all-cause and cardiovascular disease (CVD) mortality in elderly diabetic nephropathy (DN) patients in the United States.

Participants were categorized into three GNRI-based groups: (1) moderate to severe malnutrition (M/S) risk (< 92), (2) low risk (92-98), and (3) no risk (> 98). The primary outcomes were all-cause and CVD mortality. Cox proportional hazards regression and competing risk analysis were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

Among 1790 DN patients (mean age 71.24 ± 7.17 years; weighted 55.0% male, 45.0% female), over 11,724 person-years (mean follow-up 6.56 ± 4.59 years), 274 (15.3%) died from CVD and 914 (51.1%) from all causes. The M/S risk group had a 143% increased all-cause mortality risk (HR 2.43; 95% CI, 1.25-5.80), while the low risk group had a 56% increased risk (HR 1.56; 95% CI, 1.19-2.38), compared to the no risk group. No significant correlation was observed between GNRI and CVD mortality. In gender-specific analysis, the M/S risk group had a higher all-cause mortality risk in males (HR 2.50; 95% CI, 1.04-5.99) than in females (HR 1.62; 95% CI, 0.83-3.15).

A lower GNRI is associated with higher all-cause mortality in elderly DN patients, particularly in males, but not with CVD mortality. GNRI may be a useful prognostic tool for mortality risk assessment in this population.